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Topic: Acromion

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Shoulder

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	Arthroscopic Acromioplasty / Cuff Debridement - Wheeless' Textbook of Orthopaedics
		- the entire undersurface of the antero-lateral acromion is cleared of soft tissue using intra-articular cautery inorder to limit bleeding;
		- once the bursal tissue is removed from the undersurface of the acromion, cautery is then used to remove bursal tissue and the deltoid
		- ideally, the portion of the acromion which extends anterior to the anterior edge of the clavicle should be removed (this is often about
	www.wheelessonline.com /ortho/arthroscopic_acromioplasty_cuff_debridement_1 (1600 words)

	II. Osteology. 6a. 2. The Scapula (Shoulder Blade). Gray, Henry. 1918. Anatomy of the Human Body.
		At birth, a large part of the scapula is osseous, but the glenoid cavity, the coracoid process, the acromion, the vertebral border, and the inferior angle are cartilaginous.
		The base of the acromion is formed by an extension from the spine; the two separate nuclei of the acromion unite, and then join with the extension from the spine.
		Failure of bony union between the acromion and spine sometimes occurs, the junction being effected by fibrous tissue, or by an imperfect articulation; in some cases of supposed fracture of the acromion with ligamentous union, it is probable that the detached segment was never united to the rest of the bone.
	www.bartleby.com /107/50.html (1934 words)

	Precision Acromioplasty in Arthroscopic Subacromial Decompression of the Shoulder
		This technique entails anterior exposure of the subacromial space with limited deltoid detachment from the acromion, resection of the coracoacromial ligament and inflamed subacromial bursa, and removal of the anterior lip and undersurface of the anterior process of the acromion.
		In this inverted position, the floor of the viewing compartment is the undersurface of the acromion and the roof is the superior surface of the rotator cuff.
		The burr sheath is applied to the posterior acromion to maintain the appropriate plane of resection during the sweeping advance of the burr tip.
	www.orthonet.on.ca /shoulderscope/arthroscopic_subacromial_decomp.htm (2684 words)

	Scapula: acromion
		The flattened acromion projects anteriorly from the lateral end of the spine, sloping gently upwards.
		The posterior border of the spine and the lateral border of the acromion meet at the acromial angle.
		The acromioclavicular (AC) joint is a plain synovial joint between the small oval facet on the lateral end of the clavicle and the facet at the medial aspect of the acromion.
	www.primalpictures.com /gallery/SportsShoulder/Contents/Anatomy_text/Bone_Regions/Scapula_acromion.html (233 words)

	John S. Rogerson, Orthopaedic Surgeon - Surgical Techniques for the Shoulder and Elbow
		Ablate or transect the coracoacromial ligament with the cautery unit or shaver and resect the anterior 3 to 4 mm of acromial bone from the anterolateral corner to the AC joint with burr.
		The burr is advanced anteriorly using the posterior half of the acromion as a "cutting block" to remove the bone with a sweeping motion medially to laterally.
		The anterior hook of the acromion is resected and the undersurface flattened in AP plane (Figure 10-5).
	www.orthorogerson.com /pubsurgtech.htm (1239 words)

	Does Your Patient Really Need Acromioplasty?
		in 1972 stated that the principle cause of impingement was the abnormal morphology of the anterior acromion impinging on the superior or bursal side of the supraspinatus.
		While a small percentage of the population may be born with a hooked anterior acromion, the most common cause of impingement symptoms is intrinsic pathology.
		An important function of the anterior acromion and coracoacromial ligament is to act as a necessary passive stabilizer against superior migration of the humeral head.
	www.chiroweb.com /archives/20/05/05.html (651 words)

	The acromion, the coracoid and the coracoacromial - Rotator Cuff Relevant Anatomy and Mechanics.
		The acromion is a scapular process arising from three separate centers of ossification--a preacromion, a mesoacromion, and a meta-acromion.
		The coracoacromial ligament spans from the undersurface of the acromion to the lateral aspect of the coracoid and is continuous with the less dense clavipectoral fascia.
		The coracoacromial arch is the inferiorly concave smooth surface consisting of the anterior undersurface of the acromion and coracoacromial ligament.
	www.orthop.washington.edu /uw/rotatorcuff/tabID__3376/ItemID__202/PageID__404/Articles/Default.aspx (2185 words)

	Shoulder Rotator Cuff Disease
		Above the rotator cuff is a bony projection from the scapula (shoulder blade) called the acromion.
		The acromion forms the “ceiling” of the shoulder, serves as the point of origin for the deltoid muscle, and joins the clavicle (collarbone) to form the acromioclavicular (a/c) joint.
		Rotator cuff “tendonitis” is the term used to describe irritation of the tendon(s) either from excessive pressure on the acromion or less commonly from intrinsic tendon pathology.
	www.orthoassociates.com /shoulderRCD.htm (1622 words)

	KOR Personal Training, Boston Massachusetts - Impingement Syndrome (Site not responding. Last check: )
		The subacromial space is formed by the acromion and coracromial ligament anterosuperior and the superior aspect of the humeral head inferiorly.
		Bigliani studied the shape of the acromion in 140 cadavers to determine the relationship between full-thickness tears of the rotator cuff.
		As the acromion has been identified as one structural cause, there is a relative decrease in the subacromial space caused by an instability of the glenohumeral joint.
	www.korpt.com /impingement_syndrome.php (1639 words)

	wave @ play \| windsurfing \| shoulder
		Impingement is a very common problem in which the tendons of the rotator cuff (predominantly supraspinatus) rub on the underside of the acromion (the bone at the point of the shoulder).
		The problem becomes increasingly common with age, as spurs develop on the anterior acromion, and by the age of 65 years this is an extremely common condition.
		The main part of this procedure is called an acromioplasty, whereby the acromion is reshaped, and the prominent areas underneath are removed to increase the size of the space beneath it.
	www.well.com /~wave/play/shoulder.html (2138 words)

	Lake County Orthopedic Specialists - Greenleaf Orthopaedic Associates
		The acromion is the firm bone that you can feel on the top of the shoulder, just past the collar bone.
		Attached to the acromion is the deltoid, a large muscle covering the outer part of the shoulder or upper arm.
		In individuals who have tendonitis or impingement the inflamed tissue is removed and the acromion (roof) is shaved to allow more room for the rotator cuff to prevent further wearing or impingement of the cuff.
	www.greenleaforthopaedics.com /shoulderTears.html (1498 words)

	Impingement Syndrome (Site not responding. Last check: )
		The deltoid originates from the acromion (shoulder cap), the clavicle, and the spine of the scapula, and inserts halfway down the upper arm.
		Normally a bursa (sac) is interposed between the rotator cuff and the acromion.
		This occurs as the bursa is pinched between the acromion and humerus.
	www.sportsmedcenter.com /impingement.htm (770 words)

	Questions and Answers about Shoulder Problems (Site not responding. Last check: )
		The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone).
		The acromioclavicular (ah-KRO-me-o-klah-VIK-u-lahr; AC) joint is located between the acromion (ah-KRO-me-on; part of the scapula that forms the highest point of the shoulder) and the clavicle.
		Acromion — the part of the scapula (shoulder blade) that forms the highest point of the shoulder.
	www.niams.nih.gov /hi/topics/shoulderprobs/shoulderqa.htm (5456 words)

	The Physician and Sportsmedicine: Rotator Cuff Injury
		However, a tight posterior capsule may aggravate impingement because it forces the humeral head against the anteroinferior acromion as the shoulder is forward flexed (5).
		Individuals with a flat acromion (type I), demonstrated on a scapular Y view, are likely to have secondary impingement, and the underlying instability will need to be addressed.
		Those with a type II (curved) or type III (hooked) acromion may undergo subacromial decompression whereby the anterior inferior acromion is resected, converting it to type I. This is also referred to as an anterior acromioplasty.
	www.physsportsmed.com /issues/1997/06jun/wolin.htm (4011 words)

	Shoulder Impingement \| massagetoday.com
		Primary impingement is predominantly caused by the architecture of the subacromial region.
		A Type 1 acromion has a flat undersurface; Type 2 has a curved undersurface; and Type 3 is referred to as a hooked acromion.
		The hooked acromion is associated with a greater incidence of impingement syndrome.
	www.massagetoday.com /archives/2006/04/11.html (705 words)

	Fox Valley Orthopaedic Institute
		The acromion forms the roof of the shoulder and is directly above the rotator cuff tendons.
		Some athletes have an acromion with a beak, or hook, on the front which increases the likelihood of impingement.
		In these cases, a cortisone injection into the space between the acromion and the rotator cuff tendon may be necessary.
	www.fvortho.com /problems/refDisplay.asp?ID=20 (544 words)

	eMedicine - Shoulder Impingement Syndrome : Article Excerpt by Thomas M DeBerardino (Site not responding. Last check: )
		In 1972, Neer first introduced the concept of rotator cuff impingement to the literature, stating that it results from mechanical impingement of the rotator cuff tendon beneath the anteroinferior portion of the acromion, especially when the shoulder is placed in the forward-flexed and internally rotated position.
		In all Neer stages, etiology is impingement of the rotator cuff tendons under the acromion and a rigid coracoacromial arch, eventually leading to degeneration and tearing of the rotator cuff tendon.
		The supraspinatus outlet is a space formed on the upper rim, humeral head, and glenoid by the acromion, coracoacromial arch, and acromioclavicular joint.
	www.emedicine.com /sports/byname/Shoulder-Impingement-Syndrome.htm (1223 words)

	Impingement Syndrome
		The acromion type of shoulder impingement has a significant impact on prognosis; it is seen easily on MRI and typically commented on in the report.
		With a type I acromion, the prognosis is better because the acromion is relatively flat.
		The arced or curved acromion, seen with a type II or type III acromion, creates a structural irritation to the subacromion space, irritating the supraspinatus tendon.
	www.chiroweb.com /archives/23/22/09.html (864 words)

	Dorlands Medical Dictionary
		(ə-kro”me-o-klə-vik´u-lər) pertaining to the acromion and clavicle, especially to the articulation between the acromion and clavicle.
		(ə-kro”me-o-nek´tə-me) resection of the distal end of the acromion, done in the treatment of acromioclavicular arthritis.
		(ə-kro´me-o-plas”te) surgical removal of an anterior spur of the acromion to relieve mechanical compression of the rotator cuff during movement of the glenohumeral joint; called also anterior acromioplasty.
	www.mercksource.com /pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_a_10zPzhtm (1716 words)

	MMG - Patient Education Impingement Syndrome (Site not responding. Last check: )
		Usually, there is enough room between the acromion and the rotator cuff so that the tendons slide easily underneath the acromion as the arm is raised.
		The goal of surgery is to increase the space between the acromion and the rotator cuff tendons.
		The surgeon must first remove any bone spurs under the acromion that are rubbing on the rotator cuff tendons and the bursa.
	www.medicalmultimediagroup.com /pated/shoulder_problems/impingementold.html (1968 words)

	SandersClinic.net, Acromioclavicular (AC) Joint Injury!
		Above the rotator cuff is a bony mass that sits on the shoulder blade, or scapula, called the acromion.
		The acromion is the headquarters for the deltoid muscle and connects to the collarbone, or clavicle, to form the AC joint, or acromioclavicular joint.
		Gravity causes the acromion and the rest of the arm to sag, which causes the end of the collarbone to appear larger.
	www.sandersclinic.net /shlder_acjoint.html (790 words)

	Oregon Judicial Department Appellate Court Opinions
		Walther subsequently concurred in a statement from the insurer that the removal of the hook projection of the acromion had resulted in a "type I" acromion and that claimant would be able to return to her work without further recurrence of the impingement.
		That is so, claimant asserts, because the type III acromion is not a "preexisting condition" as defined in ORS 656.005(24) and, thus, is not the type of condition that must be considered when weighing factors that contribute to the cause of an occupational disease.
		In sum, if claimant's type III acromion contributed to the claimed condition, its relative contribution must be considered, regardless of whether it was a "preexisting condition" as defined in ORS 656.005(24).
	www.publications.ojd.state.or.us /A126344.htm (1299 words)

	shoulder case study
		The area between the acromion and greater tubercle is very tender and painful.
		With shoulder impingement, the space between the acromion and the head of the humerus is narrowed so that the tendon of the supraspinatus muscle rubs against the underside of the acromion.
		In the case of your patient, the shoulder impingement is not a result of any deformity of the acromion.
	www.upstate.edu /cdb/grossanat/limb_shcs.shtml (785 words)

	A Patient's Guide to Shoulder Problems- Impingement Syndrome (Site not responding. Last check: )
		Between the acromion and the rotator cuff tendons there is a bursa.
		Some people have an odd anatomy of the acromion, where the bone tilts too far down and reduces the space between the acromion and the rotator cuff.
		Usually a small part of the acromion may be removed as well to give the tendons even more space and allow them to move without rubbing on the underside of the acromion.
	www.medicalmultimediagroup.com /pated/shoulder_problems/impinge.html (1751 words)

	Lab Manual - Shoulder & Superficial Upper Limb
		Reflect the muscle by cutting its origin from the spine of the scapula and lateral border of the acromion and reflect it as far laterally as possible.
		Reflect the acromion process forward by cutting through the junction of the spine and acromion with a saw.
		As you reflect the acromion process, look for a bursa between it and the supraspinatus muscle (subacromial bursa).
	www.med.umich.edu /lrc/coursepages/M1/anatomy/html/limbs/shoulder.html (1650 words)

	anterior hooked - acromion crochu/en crochet ou bec acromial antérieur (English to French translation glossary) report ...
		The acromion is a Type III (anterior hooked) and is moderately downsloping and is impinging upon the supraspinatus tendon.
		A type III acromion is hooked - "anterior" is not really necessary and not usually specified, because the hook is always anterior (projecting forwards and downwards) as far as I know.
		NB the shape of the acromion (flat, curved, hooked) is one thing - the presence of a spur (éperon) is something different.
	www.proz.com /kudoz/1730432 (572 words)

	Arthroscopic Subacromial Decompression, James C. Esch M.D. (Site not responding. Last check: )
		Define the bony margins of the acromion and the acromial attachment of the coracoacromial ligament from the lateral portal.
		Delineate the thickness and shape of the acromion arch with the arthroscope in the lateral portal and the synovial resector in the posterior portal.
		Use the posterior acromion as a planing jig, converting the curved or hooked acromion to a straight line.
	www.shoulder.com /olasad_esch.html (1067 words)

	Current Concepts Review - Subacromial Impingement Syndrome -- BIGLIANI and LEVINE 79 (12): 1854 -- Journal of Bone and ...
		acromion is, the greater the degenerative changes are.
		of the acromion was substantially larger, in the cadavera that
		Armstrong, J. Excision of the acromion in treatment of the supraspinatus syndrome.
	www.ejbjs.org /cgi/content/full/79/12/1854 (8332 words)

	Augusta Orthopedic Surgery - Shoulder Arthroscopy
		The top of the shoulder is called the acromion and the ball rotates under the acromion when the arm is in motion.
		Under the acromion is a fluid-filled sac called a bursa.
		In a healthy shoulder, the bursa acts as a cushion, reducing friction between the ball and the acromion.
	www.augustaortho.com /shoulderarthro.htm (1127 words)

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